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瑞派替尼与舒尼替尼二线治疗晚期胃肠道间质瘤的经济性
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| 篇名： | 瑞派替尼与舒尼替尼二线治疗晚期胃肠道间质瘤的经济性 |
| TITLE： | Cost-effectiveness of second-line treatment of advanced gastrointestinal stromal tumors with ripretinib versus sunitinib |
| 摘要： | 目的 评Щ訢樜⬑栃㨷㸑栜⬑栄蠃昛蘜䬵책罋⁂含倀（GIST）患者二线治疗方案的经济性。方法基于INTRIGUE研究数据构建动态Markov模型，设定模型循环周期为6周，模拟患者15年的直接医疗成本和质量调整生命年（QALYs），以增量成本-效果比（ICER）为评价指标，比较ICER与意愿支付（WTP）阈值（我国2023年的3倍人均国内生产总值，268200元/QALY）的大小；并对模型输出结果进行单因素敏感性分析和概率敏感性分析以考察模型的稳定性。结果瑞派替尼方案的健康获益低于舒尼替尼（1.21QALYsvs.1.31QALYs），但成本更高（323401.88元vs.227532.40元），为绝对劣势方案。单因素敏感性分析结果表明，瑞派替尼和舒尼替尼费用、无进展生存状态的效用值对ICER影响较大。概率敏感性分析提示研究结果较稳定，且随着WTP增加，瑞派替尼方案具有经济性的概率始终远低于舒尼替尼，并呈下降趋势。结论在当前我国的经济背景下，与舒尼替尼相比，瑞派替尼作为晚期GIST的二线治疗方案并不具有经济性。 |
| ABSTRACT： | OBJECTIVE To evaluate the cost-effectiveness of ripretinib versus sunitinib as a second-line treatment option for patients with advanced gastrointestinal stromal tumors （GIST）. METHODS Based on the data of INTRIGUE study， a dynamic Markov model was constructed， with a cycle of 6 weeks； this model was used to simulate patients’ direct medical costs and quality- adjusted life years （QALYs） over 15 years. Using the incremental cost-effectiveness ratio （ICER） as the evaluation metric， a comparison was made between the ICER and the willingness-to-pay （WTP） threshold （3 times the per capita gross domestic product， which amounts to 268 200 yuan/QALY）. One-way sensitivity analyses and probabilistic sensitivity analyses were performed on the model outputs to examine the stability of the model. RESULTS The health benefits of ripretinib were lower than those of sunitinib （1.21 QALYs vs. 1.31 QALYs）. Still， the costs were higher （323 401.88 yuan vs. 227 532.40 yuan）， making it an inferior regimen. The results of the one-way sensitivity analysis suggested that the cost of ripretinib and sunitinib， and the health utility value in progression-free survival status had a greater impact on the ICER of the model. Probabilistic sensitivity analysis suggested that the results of the study were stable， and the probability of the cost-effectiveness advantage of ripretinib was always much lower than that of sunitinib with the increase of WTP threshold， and showed a decreasing trend. CONCLUSIONS In the current economic context of China， ripretinib does not have a cost-effectiveness advantage over sunitinib as a second-line treatment for advanced GIST. |
| 期刊： | 2025年第36卷第06期 |
| 作者： | 陈永；黄龙转；顾航烨；陈亚轻；陈吉生 |
| AUTHORS： | CHEN Yong，HUANG Longzhuan，GU Hangye，CHEN Yaqing，CHEN Jisheng |
| 关键字： | 瑞派替尼；舒尼替尼；胃肠道间质瘤；成本-效果分析；二线治疗；Markov模型 |
| KEYWORDS： | ripretinib； sunitinib； gastrointestinal stromal tumor； cost-effectiveness analysis； second-line treatment； Markov model |
| 阅读数： | 7 次 |
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